El-Okeily M, El-Bouihi M, Ricard A-S, Lefebvre-Majoufre C, Deminière C, Siberchicot F, Zwetyenga N
Service de chirurgie maxillofaciale, hôpital Pellegrin, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux cedex, France.
Rev Stomatol Chir Maxillofac. 2008 Apr;109(2):81-5. doi: 10.1016/j.stomax.2007.12.003. Epub 2008 Mar 6.
Most cancers of the oral cavity are epidermoid carcinomas. The prognosis is made on the patient's general health status and the tumoral stage. The UICC TNM staging classification system is one of the most important factors taken in consideration for the prognosis. But this classification in oral epidermoid carcinomas does not include the tumor thickness (except for T4 tumors). Several studies demonstrated that tumor thickness could influence the prognosis in epidermoid carcinoma and other types of cancers. The aim of our retrospective study was to assess the prognostic value of tumor thickness in oral epidermoid carcinoma.
The study included patients with mouth floor or mobile tongue epidermoid carcinoma classified T1N0, T2N0 and T3N0 between 1985 and 2005. All patients were treated with a curative intention. A pathologist analysed the tumor thickness and cervical lymph nodes. All the slides were examined to measure tumor thickness in millimetres.
Three hundred and five patient files were reviewed and 124 patients were included, with 94 men (75.8%), and a mean age of 59.3 years (17-93). The mean and median tumor thickness were respectively 7.7 and 6.5 mm (0.4-30). The median tumor thickness was chosen for the study. There was a statistically significant link between the five-year probability of global survival and the initial tumor thickness and between neck node invasion and tumor thickness (p<0.05).
This study suggests that tumor thickness should be taken in consideration in T1N0, T2N0 and T3N0 mouth floor and mobile tongue epidermoid carcinomas. In the future, the clinical evaluation of tumor thickness will help determine the therapeutic management.
大多数口腔癌为表皮样癌。预后取决于患者的总体健康状况和肿瘤分期。国际抗癌联盟(UICC)的TNM分期分类系统是预后考虑的最重要因素之一。但口腔表皮样癌的这种分类不包括肿瘤厚度(T4肿瘤除外)。多项研究表明,肿瘤厚度可影响表皮样癌和其他类型癌症的预后。我们这项回顾性研究的目的是评估肿瘤厚度在口腔表皮样癌中的预后价值。
该研究纳入了1985年至2005年间口底或活动舌部表皮样癌且分类为T1N0、T2N0和T3N0的患者。所有患者均接受根治性治疗。一名病理学家分析肿瘤厚度和颈部淋巴结情况。检查所有切片以测量肿瘤厚度(单位为毫米)。
回顾了305份患者档案,纳入124例患者,其中男性94例(75.8%),平均年龄59.3岁(17 - 93岁)。肿瘤平均厚度和中位数厚度分别为7.7毫米和6.5毫米(0.4 - 30毫米)。研究选用中位数肿瘤厚度。总体生存率的五年概率与初始肿瘤厚度之间以及颈部淋巴结侵犯与肿瘤厚度之间存在统计学显著关联(p<0.05)。
本研究表明,对于T1N0、T2N0和T3N0的口底及活动舌部表皮样癌,应考虑肿瘤厚度。未来,肿瘤厚度的临床评估将有助于确定治疗方案。